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Observational Study
. 2021 Apr;25(4):401-409.
doi: 10.1007/s10157-020-01996-4. Epub 2021 Jan 4.

Hypokalemia in Patients with COVID-19

Gaetano Alfano  1   2   3 , Annachiara Ferrari  4 , Francesco Fontana  5 , Rossella Perrone  4 , Giacomo Mori  5 , Elisabetta Ascione  5 , Riccardo Magistroni  4   5 , Giulia Venturi  6 , Simone Pederzoli  7 , Gianluca Margiotta  7 , Marilina Romeo  7 , Francesca Piccinini  7 , Giacomo Franceschi  8 , Sara Volpi  8 , Matteo Faltoni  8 , Giacomo Ciusa  8 , Erica Bacca  8 , Marco Tutone  8 , Alessandro Raimondi  8 , Marianna Menozzi  8 , Erica Franceschini  8 , Gianluca Cuomo  8 , Gabriella Orlando  8 , Antonella Santoro  8 , Margherita Di Gaetano  8 , Cinzia Puzzolante  8 , Federica Carli  8 , Andrea Bedini  8 , Jovana Milic  9   8 , Marianna Meschiari  8 , Cristina Mussini  8 , Gianni Cappelli  4   5 , Giovanni Guaraldi  8 ; Modena Covid-19 Working Group (MoCo19)
Collaborators, Affiliations
Observational Study

Hypokalemia in Patients with COVID-19

Gaetano Alfano et al. Clin Exp Nephrol. 2021 Apr.

Abstract

Background: Patients with COVID-19 experience multiple clinical conditions that may cause electrolyte imbalances. Hypokalemia is a concerning electrolyte disorder closely associated with severe complications. This study aimed to estimate prevalence, risk factors and outcome of hypokalemia in a cohort of patients with confirmed COVID-19.

Methods: A retrospective analysis was conducted on 290 non-ICU admitted patients with COVID-19 at the tertiary teaching hospital of Modena, Italy, from February 16 to April 14, 2020.

Results: Hypokalemia was detected in 119 out of 290 patients (41%) during hospitalization. Mean serum potassium was 3.1 ± 0.1 meq/L. The majority of patients (90.7%) patients experienced only a mild decrease in serum potassium level (3-3.4 mEq/L). Hypokalemia was associated with hypocalcemia, which was detected in 50% of subjects. Urine potassium-to-creatinine ratio, measured in a small number of patients (n = 45; 36.1%), revealed an increase of urinary potassium excretion in most cases (95.5%). Risk factors for hypokalemia were female sex (odds ratio (OR) 2.44; 95% CI 1.36-4.37; P 0.003) and diuretic therapy (OR 1.94, 95% CI 1.08-3.48; P 0.027). Hypokalemia, adjusted for sex, age and SOFA score, was not associated with ICU transfer (OR 0.52; 95% CI 0.228-1.212; P = 0.131), in-hospital mortality (OR, 0.47; 95% CI 0.170-1.324; P = 0.154) and composite outcome of ICU transfer or in-hospital mortality (OR 0.48; 95% CI 0.222-1.047; P = 0.065) in our cohort of patients.

Conclusions: Hypokalemia was a frequent disorder in subjects with COVID-19. Female sex and diuretic therapy were identified as risk factors for low serum potassium levels. Hypokalemia was unrelated to ICU transfer and death in this cohort of patients.

Keywords: COVID; Coronavirus; Electrolytes; Hypokalemia; Magnesium; Potassium.

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Conflict of interest statement

The authors have no conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Flow chart of patients’ selection
See this image and copyright information in PMC

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